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�ERMIT APPLICATIO� <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />TE ADDRESS: PROPERTY TAX # PERMIT # <br />►�z�o t�Q�4M A�L vo�3�3Z35vo� � oc� l' i�31C� - <br />=GAL for new construction: Short Plat/subdivision �,�U�,II ��� 1'� Lot No. j 7 (attach copy of long legal description) <br />OWNER Fi2/JN I�. PAT1 N� Phone/E-mail �� �� Z�% � y v <br />Address City/State/Zip <br />APPLICANT: _ Owner _ Owner's Agent �Contractor _ Contractor'S A9Bf1Y _ TBflBfll (must provide a letter of consent from the owner to do work �� cr,e sPa�e� <br />CONTRACTOR <br />,ddress � �Z� (.�� ��L N� i' I�WL`i�U� � i r (d,J <br />�Ri'f BUSINESS NAME <br />i�xd�l.Ll�'t.S C-�iOlcl f-(�"v�C TMPI�.�l1L'N`�11 Z�L�. <br />L&ILic.# <br />Phone/Email <br />I�EI L C��f-1� <br />Phone/E-mail <br />� COE Bus. Lic. # <br />NF.�1_f�k-1I � <br />lN��,z e c�ma � �. c� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � IS.Joc� . u� <br />Existing Use of Building �5(i��.1�� �l' IN(pl� � LC.,`�% HEAT SOURCE: <br />Proposed Use of Building �FSI�I�LC� Gas Electric� Other <br />Building type: �Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />CVa2G,u�t fs 3 tNT� �e�-S , /lJl-�.,.�N Sy,�wf�, �s�.� /�F- ib� �; , �(��'��5 ��Gl � <br />fu,'{ F.�.... . <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Adc(�i _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />' Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />�—'° Gas range <br />� Clothes dryer <br />Rangehood <br />Exhaustfan L�7 � <br />' Heat pump <br />Unit heater <br />Boiler <br />; Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn � Alteration _Repair <br />Show Number (#J of fixtures <br />� Toilet <br />Bathtub <br />Lavatory (wash basin) <br />( Shower <br />Kitchen sink & disposal <br />Dishwasher <br />� Clothes washer <br />' Water heater <br />' Sink (service/bar/mop/etc.) <br />' Backflow preventer <br />' Urinal <br />' Drinking Fountain <br />Floor drain <br />Grease trap <br />' Roof drains <br />Medical Gas <br />: Other: <br />Other: <br />I hereby ceRify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />l � <br />�---, l0 � 3 � z�3 <br />Owner/Aut rized gent Signature Date (Revised 6/2012) <br />